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Aspirin a Day Recommendation Undergoes Changes

woman holding aspirin tabletsYou’ve likely heard the saying “an aspirin a day keeps the doctor away” – but researchers from the US Preventive Services Task Force have re-examined their advice regarding what many Americans consider a fairly routine part of their day. The task force recently issued a new draft recommendation for those thinking about taking a baby aspirin to ward off a first heart attack. Tufts Medical Center Interim Chief Scientific Officer Dr. John Wong is a member of this group and explains there have been substantial changes made to recommendations for people from their 40’s up to their 70’s.

“These changes concern trying to prevent a first stroke or heart attack, said Dr. Wong. Our focus is to keep people in this nation healthy and help them live longer. Stroke and heart attack cause the death of 1 in 3 people in this nation.” The task force last examined the recommendations surrounding aspirin in 2016. “Our recommendations really are focused at starting aspirin,” said Dr. Wong. “Any time a person is thinking about taking a medication, even if it’s an over-the-counter medicine like aspirin, we encourage them to have a conversation with their clinician. There are potential significant harms such as bleeding in the stomach or large intestine, or bleeding in the brain. And these risks increase with age.” Here’s a look at how the changes affect adults in different age groups: 

If you are in your 70’s:

The risk of bleeding increases as you age, and aspirin also increases bleeding risk. The task force now recommends NOT starting to take a baby aspirin for preventing a first attack or stroke since the risk of bleeding at this age outweighs the potential benefit.

If you are in your 60’s:

The task force found that the potential harm from bleeding cancels out any potential benefit for preventing heart attack or stroke, so starting an aspirin regimen isn’t recommended.

If you are in your 50’s:

If you are in this age group, you are encouraged to have a conversation with your primary care physician (PCP) since the balance of potential benefits and harms favors a small benefit for some. 

If you are in your 40’s:

It’s also recommended that those in their 40’s sit down with their PCP since the task force found that SOME people in this age group did show a small benefit from beginning a daily aspirin regimen.

“Although millions take aspirin safely to prevent a first heart attack or stroke, the main point to take away is there risk of possible harm, as the risk of bleeding goes up as people age,” said Dr. Wong. “There are some people who actually can die from these complications, so speak with your trusted clinician to see if starting aspirin is right for you.” Tufts Medical Center Chief of Cardiology Dr. James Udelson says doctors can assess your risk of first attack using an online calculator. “We plug in very simple data which includes information such as your age, gender, race, blood pressure, and weight,” said Dr. Udelson. “This tool gives us a number which is your ten-year risk of having a heart attack.”

Dr. Udelson points to the American Heart Association’s Life’s Simple Seven – which are 7 risk factors associated with heart attack. “These 7 behaviors are things that most of us can control,” said Dr. Udelson. “If you manage your blood pressure, control cholesterol, reduce blood sugar levels, eat a healthy diet, exercise, lose weight and stop smoking, the risk of having a heart attack or stroke is actually pretty low.” 

If you are currently taking an aspirin a day to prevent heart attack or stroke, both Dr. Wong and Dr. Udelson recommend having a conversation with your physician to determine the best course of action going forward.